Major Changes to the National ART Programme in 2011 PMTCT, Paediatric, Adult ART integration Strategic phasing out of Stavudine CD4 threshold increase
CHALLENGES Quantity versus Quality Demand versus Supply Shortage of health care personnel Toxicity of the first line regime
CHALLENGES Early ART mortality ART failure ART delivery Infrastructure Limited Laboratory Back up
DRUG SUPPLY CONTINUES Possible reasons for the Drug Shortage? Increased # of clients on non standard regime. Inadequate financing or under- budgeting. Inefficiencies in supply and distribution chain.
SELECTED POINT EXAMPLES OF DRUG SUPPLY Drug shortage is the main problem June 2010 3TC = 0, NVP = 117 August 2010 3TC = 0, NVP = 0 Sept. 2010 3TC = 55, NVP = 100